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Challenging ideas in mental health

1.2.2 Boundaries of difference

One of the things that language does is define and give a name to differences between people – to delineate the boundaries that separate them. In the mental health field, the ‘mad’ are at one end of the social divide that separates the ‘normal’ from the ‘abnormal’. They are ‘the other’, a point made in the article by Perkins (above): ‘To be mad is to be defined as “other”’.

This is a recurring theme in the mental health field. In the following passage Abina Parshad-Griffin, Chair of the Mental Health Action Group for the Disability Rights Commission (DRC), reflects on ‘otherness’ and what it means to be ‘the other’:

I could use different aspects of who I am that make the whole of me, as a kind of through-the-looking-glass. And I can give an example: being mixed race, if I had to fill in different forms in various countries, I'd have to tick different boxes. So in South Africa, I would have been ‘coloured’. In America, I would be ‘black’ because one drop of Black blood makes you ‘black’, and excluded. In South America, I could possibly be ‘mixed race’, or I could even pass for ‘white’ when you have the hierarchy of colour coding. But guess what I'm called in England or the UK? ‘Other’. And it's that otherness that is part of my identity, and I believe that mental health discrimination is that otherness which is sometimes indefinable. But you pick it up – this overt and covert discrimination. I call it ‘psychophobia’: fear of mental illness. And there are certain conditions. Like somebody asks me, ‘What do you do?’ And I say, ‘Schizophrenia.’ You know that's going to be a conversation-stopper and you will also know that it's going to be associated with violence, with antisocial behaviour, which is not at all the case. That's rare.

(Disability Rights Commission, taped conversation, n.d.)

To be ‘other’, in many instances, is to be on the wrong side of the boundary. The fact that Parshad-Griffin is mixed race gives her an officially designated category of ‘other’ in the UK. In addition, of course, her experience of mental distress reinforces her ‘otherness’. To be regarded as ‘other’ is to be treated differently, which often means prejudice and discrimination. ‘Otherness’ comes into play at all levels, but especially, it seems, when mental distress triggers ‘psychophobia’ in the people around. Although Parshad-Griffin's situation also features ‘double discrimination’ (Baxter et al., 1990) because of her mixed race designation, in many ways it is typical of the experiences of people who have periods of mental distress. Psychophobia leads to prejudice and discrimination. This may be something you have experienced yourself or have witnessed in others.

The point of creating ‘others’ or a ‘them’, according to Harper (2002a, p. 8), is that it projects problems on to other people so that we ‘get to see ourselves as normal’. May (2000) suggests that the ‘us’ and ‘them’ ideas that are prevalent in the mental health services should be challenged: ‘Such ideas assume that there are “ill” people and there are “well” people, and an uncrossable void exists between them’ (p. 25).

Being seen as someone with mental health problems may result in discrimination, often of a severe kind, as many people have found to their cost. The experience of being on the ‘other’ side of the mental health/distress boundary may be accompanied by unemployment, breakdown of relationships, low income and poor housing.

Activity 2: A quiet night on Roundhay Wing

1 hour 0 minutes

You should now watch the three video sequences below, ‘A quiet night on Roundhay Wing’. This is a story of people who have been designated as ‘other’ and confined to the psychiatric wing of St James's Hospital in Leeds.

The film was scripted and acted by mental health service users/survivors. It is hard-hitting, especially in its references to the people and practices that have dominated – and defined – their lives, often over many years. It is a true story in the sense that it is grounded in and reflects people's real experiences, but the events portrayed did not actually take place.

Watch the video clips now. When you write your notes afterwards, you may find it helpful to divide them into:

your reactions to what you saw and heard; in other words, what you felt as you watched it;

your reflections on the key messages: what you thought after the film had ended.

Transcript: Clip 1

It's an owl in sheep's clothing, white lions roaring on the town hall steps.

Pensioner:

It's a nightmare on South Parkway after dark.

Motorist:

The best thing to come out of Leeds is the M62.

Angel:

It's said that Rudolf Steiner came here for a few hours once and left never to return.

Rudolf Steiner:

We stayed as short time as possible in this curiously featureless modern city. Its aspect is dour, I doubt it will be possible to base a school here. The river is pestilent with dyes from the mills. There are bad spirits in this place! A deep fog pervaded for several hours which marred our visit to the workhouse

St James:

Which later became St James's hospital, now they call it Jimmy's. Bloody heathens.

Angel:

As the millennium comes and goes, see Gledhow Wing presenting its façade of red brick and glass to the west. A proud monument to maternity and birth, to rebirth and regeneration. But this is Roundhay wing, no direct sunlight reaches this place. It nestles between other grander hospital blocks for real medicine, like oncology, cardiology and having a nose that's slightly too big. It's like an old shed that some eccentric has refused to sell so that the red towers have sprung up around it leaving a little island of the past at their feet. It is the year 2000. The cries of those desperate to leave ...

(lots of people) :

Let us out, let us out ...

Angel:

... are matched by those who are desperate to enter ...

(lots of people) :

Let us in, let us in ...

Angel:

... but this is the only service in the world where the customer is always wrong.

The Doctor:

Those who want to get into a place like this are obviously suffering from disorders of the personality and are untreatable. So we cannot let them in. Those on the other hand who wish to leave do not yet realise that they are ill which is the first step to recovery, so we cannot let them out.

'Cured' patient:

Please let me stay. Please. I like it here, the food's nice, its warm. I want to stay forever, please. I really like it here.

The Doctor:

Ah, she's cured. Nurse, discharge the patient.

Nurse O'Render:

Come on sunshine.

'Cured' patient:

No, I'm not cured. Get off me ... No, no ...

Angel:

Some people find a way out unexpectedly.

'Discharged' patient:

The doctor said to me 'Are you hearing voices?' And the voices said to me 'Say no'. So I said no and then they let me go.

Angel:

Now night has fallen like a sedative. Stillness covers the sleepers like a new duvet. The soft heat rises from pipes that were old when spitfires flew over the city and the sweat steam and you wake up full of strange dreams

1st Sleeper:

Penalty shoot out in front of the old Cop. Everton, fourth round replay. Bloody awful night, pissing down. I've got to score to keep us in. The goalkeeper's my old French teacher.

2nd Sleeper:

Middleton Wood, but it's a jungle. I've been lost for days. Then I come to a clearing and there's Tesco's. I go in to buy some bread and the checkout girl turns into a leopard

3rd Sleeper:

Trying to catch a train. A big old steam engine with the name plate William Wordsworth. It's just started to leave and I'm gaining on it until I feel something holding me back. I look down and there's all these daffodils, thousands of them grabbing at me ankles.

Angel:

The walls are nailed and painted shut but outside you can sense a raw west Yorkshire night. It's a quiet night down in the doctor's flat where Dr Uberdose fuddles his eiderdown as he dreams of a ward round at the People's Dispensary for Sick Animals on Leyland Street

The Doctor:

This dog is much too dozy. I prescribe an antidepressant.

Nurse O'Render:

But sir, he's been hyperactive all day and he kept us up half the night.

The Doctor:

What, barking?

Nurse O'Render:

Yeah

The Doctor:

I prescribe cognitive behavioural therapy and 6,000 mg of chlorpromazine!

Nurse O'Render:

Right.

1st Lost Soul:

It's a bit parky!

2nd Lost Soul:

It smells of wool and coal, bad for the chest.

3rd Lost Soul:

Chips with curry. And I'll have some scraps on that if you've got them.

1st Lost Soul:

Nazi graffiti.

2nd Lost Soul:

Breaking glass.

3rd Lost Soul:

Guard dogs barking, hallucinating burglary, at each sad city footstep.

Angel:

It's a quiet night down along the main corridor where the ghosts of all the ages mingle and drift in flood strip lighting so bright you half expect Man United or the Chicago Bulls to come trotting out.

Speaker:

But not everyone is asleep. On the women's ward transactions are being made in Roundhay Wing's main currency.

Well, here's a bit of baccy, filters. Not fussy about filters are you?

2nd Lost Soul:

I'll take as it comes me love. Have you got a roach though. I like a bit of roach in me joint.

3rd Lost Soul:

Well, haven't got a plant here but under me bed there is one.

2nd Lost Soul:

I won't tell those Gestapo bastards in the office about this. Call themselves nurses ...urghh

3rd Lost Soul:

Can we get a light on here. I can't roll in the dark.

2nd Lost Soul:

If we put the light on the nurses will come and they'll put us to bed.

3rd Lost Soul:

Bloody hell, here's a fag of sorts.

2nd Lost Soul:

Thank you love

3rd Lost Soul:

That's it until tomorrow.

2nd Lost Soul:

That's just what I need.

Angel:

In the treatment room a blue spark flickers from a loose wire as if the shock machine is dreaming. In the TV lounge the night nurse stares at an empty TV screen although the programme finished three hours ago and the screen is just a swarm of electronic insects.

Speaker:

In a dormitory for eight, enclosed by Dorothy Perkins curtains, about to wake from a three-day sleep induced by an enormous dose of Largactyl introduced intravenously into a delicate part of the anatomy - Jonathan X.

Jonathan X:

Bloody leave me alone.

Angel:

In his night stallion he is fighting off an army of white-coated nurses, shouldering arms of three foot hypodermics, points glistening like bayonets at the Regent Street Territorial Parade.

Voice:

I've got you sunshine.

Jonathan X:

What the bloody hell's going on? Where am I?

2nd Lost Soul:

He wants to know where he is.

Jonathan X:

What is this place?

3rd Lost Soul:

It's the end of the line

1st Lost Soul:

The last chance saloon. It's limbo baby

Jonathan X:

Can't you talk some sense? Where am I?

1st Lost Soul:

You're lost boy, like me. Went for a paper 20 years ago and got abducted by aliens on the 93 to Cookridge. Never been seen since. Used to sing in working men's clubs. I did it my way.

Voice:

Not now you don't sunshine.

Jonathan X:

But how long have I been here?

2nd Lost Soul:

Forever.

Jonathan X:

But I don't belong here, it's all been a mistake.

2nd Lost Soul:

That's what they said about me. You don't belong here love, just a crack up doing your A' levels. You'll be alright in six months. That was 12 years ago. I write a diary in a special code so they can't get at me.

Jonathan X:

But I'm not like the rest of you.

1st Lost Soul:

Ha, ha, he's not like the rest of us.

2nd Lost Soul:

That's the whole point, you ninny.

3rd Lost Soul:

None of us is like the rest of us. That's why we're here.

Jonathan X:

I've got to get out.

All Lost Souls:

He's got to get out.

Jonathan X:

No, but I have, I've got to get out. I've go somewhere to be, I've got to meet someone.

1st Lost Soul:

Well, technically the boy is free to leave.

2nd Lost Soul:

... but of course if he does try to ...

3rd Lost Soul:

... they'll slap him on a Section and they'll make him stay.

1st Lost Soul:

It's like the Hotel California.

2nd Lost Soul:

Yeah. You can check out, but you can never leave.

3rd Lost Soul:

Except it's in West Yorkshire.

1st Lost Soul:

You can say ta'ra, but you can never flit.

Jonathan X:

Look isn't there any way I can get out?

1st Lost Soul:

Only with the permission of the Head Honcho.

Jonathan X:

Who's the Head Honcho?

2nd Lost Soul:

Only the one who writes the pardons. The one who gives the go head for discharge. Remo himself.

Jonathan X:

Remo?

3rd Lost Soul:

The Responsible Medical Officer.

Jonathan X:

How do I get to see Remo?

1st Lost Soul:

You can't.

2nd Lost Soul:

He'll see you when he's good and ready.

3rd Lost Soul:

And you won't even know who he is.

1st Lost Soul:

He's a shape changer.

2nd Lost Soul:

Sometimes he'll be round and friendly.

3rd Lost Soul:

But the next time you see him he'll be seven foot thin and he'll shout the ward down.

1st Lost Soul:

And sometimes he'll be like the good strong father you always wished you'd had.

2nd Lost Soul:

Then he'll cheat you out of your weekend leave and laugh in your face.

3rd Lost Soul:

And the beauty is, you never know when he's going to come.

1st Lost Soul:

The day of the ward round, you can stand around all day and he doesn't come.

2nd Lost Soul:

The next day, for no good reason at all he'll be there sharing a laugh in the staff room.

Transcript: Clip 3

But they're too stiff. Look, they can hardly walk, they're shaking all over.

2nd Lost Soul:

They must be Largactyls then. We're in some kind of lost world. Look at those mountains of grey ash and these piles of ancient armchairs everywhere.

1st Lost Soul:

It's the valley of the eternal day centre. The land where the television is never switched off. Listen. Look at that murky brown liquid bubbling up.

2nd Lost Soul:

It's tea. We must be in a huge underground reservoir. We must be close to the level of the water table.

3rd Lost Soul:

Or the tea table.

Jonathan X:

Look, over there.

1st Lost Soul:

Argh ... skeletons.

2nd Lost Soul:

All in rows of armchairs.

3rd Lost Soul:

And on the armchairs, mugs of tea.

1st Lost Soul:

And it's still hot.

1st Lost Soul:

And look. Some of them have still got burnt out stubs in their mouths.

2nd Lost Soul:

They died with their fags in.

(lots):

Anybody got a fag? Anybody got a ....? Can we play ping pong? Go on can we play ping pong? I want my cigarettes, I want my cigarettes. Give us a fag mate will you?

3rd Lost Soul:

We've got to keep moving, this is no place to hang around.

1st Lost Soul:

Look out ... argh ...

Speaker :

I want my cigarettes ...

1st Lost Soul:

We've made it to the foothills.

2nd Lost Soul:

Do you hear music?

3rd Lost Soul:

What is it?

Jonathan X:

I don't know but we'd better go and see.

Magic Bullet Maker:

He don't take his medicine ... come back in a rewind style ... hub dub toil and trub, take another tablet and stick it in your gob, you're never gonna be no-one, you'll never get a job, if you don't take your medicine, you don't take your drug. Take a little chemical from Porton Down, mix it, wax it, stir it down. Take a little chemical inside your head, see what that does to your head, cos you need rewiring your seratonin sucks, you ain't been takin your prescribed drugs. Hey you want a little irony, try this for size, I've forgotten the second verse but here it comes again

1st Lost Soul:

It's the magic bullet maker.

2nd Lost Soul:

What can we do?

Jonathan X:

There's only one thing that will work against magic bullet makers. Give me that aromatherapy gun.

We are the top pharmaceutical crew, whatever you want we can do it for you, we can take you up, we can take you down, we can take you on a trip to the weird side of town, and when you come back you just won't be the same because you'll be dancing our little game and you want some irony try this for size, I could be up for the Nobel prize, for all my work on the human condition and all of the time I've been raking in the millions. Hub, dub, toil and trub, take another tablet and stick it in your gob. Hub, dub, toil and trub, take another tablet and stick it in your gob ...

Jonathan X:

Go!

Magic Bullet Maker:

Hub, dub, toil and trub, take another tablet and stick it in your gob ...

Jonathan X:

OK, the game's up.

Magic Bullet Maker:

What the hell's going on?

Jonathan X:

We're wise to you. Tip out that cauldron.

Magic Bullet Maker:

What the hell're you doing. That was high quality medicine. You're totally irresponsible.

1st Lost Soul:

No, it wasn't. It was crap.

Magic Bullet Maker:

Oh, ok. What's the deal? What do you want?

Jonathan X:

We want to be released from the spell of Roundhay Wing and we've been told only the king of the magic bullet makers can do it.

Magic Bullet Maker:

No, no-one's seen the king for 15 years. He fears contamination. He lives in a protected zone. His food is placed in a special chamber and his rooms are cleaned with a special filter. He only ever communicates by email.

Jonathan X:

Ok, come on, this way.

Magic Bullet Maker:

Oh, no, you can't go in there.

The King:

And there were tulips I seem to recall. Yes, we bought them for the room, crimson tulips. You were standing by the window as a train went past, so you didn't hear what I said properly. You turned around with that smile of yours. Rosemary for remembrance, but what is for forgetting?

Jonathan X:

We've come to demand that you release us from the spell of Roundhay Wing.

The King:

What can I do?

3rd Lost Soul:

Well, everyone says you have the power.

The King:

Alas, would that it were so.

1st Lost Soul:

What?

Magic Bullet Maker:

He means chance would be a fine thing.

2nd Lost Soul:

Oh, you mean you don't have the power?

The King:

Oh sure I have power. Power is easy. I am the owner of a multinational industrial pharmaceutical empire. I have power, but power isn't enough you see.

Jonathan X:

What do you mean?

The King:

Look, I'm tired, I've made billions and where did it get me? I'm alone. I can spend a million every day on some new toy, holiday wherever I like. I could buy a country if I wanted but what on earth would I do with it. No, it seems to me that I've been searching for something that no longer exists.

3rd Lost Soul:

That photograph?

The King:

My Rosemary, gone, forever. She loved me but I felt I had to prove myself to her. I had to make money and give her everything she wanted but she only wanted ... she only wanted ...

2nd Lost Soul:

Love?

The King:

Yes, love. If only I knew then.

2nd Lost Soul:

But it's not too late. No, it's never too late. Julian.

The King:

Rosemary, it's you. My Rosemary, and you've learned to play the violin.

2nd Lost Soul:

Yes, oh Julian sweetheart. How could I ever leave you?

The King:

Because I was stupid, foolish, greedy and bad tempered.

2nd Lost Soul:

Yes, there was that. But now we're together we'll never be parted.

The King:

I declare a national holiday.

1st Lost Soul:

But you can't do that. Only the Queen can do that.

The King:

Oh, I'll email her. She'll be alright about it.

1st Lost Soul:

Oh.

The King:

I intend to disband my empire right now.

Magic Bullet Maker:

What?

The King:

Yes, from now on my factories will only be used for the manufacture of wholesome goods.

Magic Bullet Maker:

But you can't do that. What about me?

The King:

I've been thinking. It seems to me I built this empire because I wanted to forget. Perhaps I wanted the world to forget. If everything was forgotten then perhaps I could be free. But now I know true freedom only comes when you can remember everything. Look I'll see you're alright. You can do the music.

Magic Bullet Maker:

Ah ... cool.

The King:

I'll take out a subscription to Green Peace and send a million immediately to the Zapatistas. Oh I've been looking forward to this for a long time.

Jonathan X:

Well, what about our freedom?

The King:

How do you mean?

3rd Lost Soul:

Well, everybody seems to think that you can set us free.

The King:

Look, it served my purpose for people to think that I was in charge of everything, but the truth is I have no power at all. You're free already.

All

Oh.

Voice:

But tomorrow, when we wake up we'll still be on Roundhay Wing.

The King:

No, you see, you have woken up already. Now no-one can make you go back.

Voice:

We don't have to go back?

Angel:

And they never did. They escaped into the spaces. And as dawn came up over East Leeds, Harehills gleamed like the new Jerusalem. And you could almost believe that God sees every sparrow fall after a quiet night on Roundhay Wing.

1st Lost Soul:

Yeah. We were down and we were out. We thought there was nothing to shout about.

2nd Lost Soul:

We were down in the mouth we had a long face and the treatment we got was such a disgrace.

3rd Lost Soul:

But we didn't give up and we didn't lie down because we knew better times were coming around.

Jonathan X:

So we got out at last, now it's all in the past and we know these times are going to last.

The King:

Because being mad is not all bad, when you realise it's the world that's sad.

Discussion

This a thought-provoking play. It aroused a mixture of reactions in the course team when we watched it together. It is easy to identify with the people who are the ‘others’ in society's terms, but it may be harder to accept their views of those they regard as their oppressors and gaolers. Doctors, nurses, hospitals, day centres and drug companies all come in for criticism. Whatever your views, record them fully now.

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